Anthony J Dickerson , PA
Physician Assistant - Medical • Melbourne, FL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Anthony Dickerson has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Anthony Dickerson, PA was a registered Physician Assistant - Medical practicing in Melbourne, FL. Throughout an active medical career spanning 13 years, Anthony Dickerson provided care at the practice location at 1251 HICKORY ST until profile deactivation on 2019-08-06.
Practice Location & Contact Primary Location
1251 Hickory St
Melbourne, FL 329013221
Specialty Benchmarks & Practice Insights
Comparative analytics for Physician Assistant - Medical in Melbourne, FL
Practicing in Melbourne, FL (2836 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 363AM0700X
Definition to come...
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Family Medicine - Adult Medicine
Doctor of Medicine (M.D.)
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on August 06, 2019
NPI status registered as active in NPPES database
Registered at 1251 HICKORY ST, MELBOURNE, FL 329013221 (Tel: 3217233113)
Registered at 202 SAND PINE RD, INDIALANTIC, FL 329032116 (Tel: 3217771348)
Recorded as ANTHONY DICKERSON, PA
Physician Assistant (License #PA2448 in FL)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
202 Sand Pine Rd
Indialantic, FL 329032116
Phone: 3217771348
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